Pre-Menstrual Dysphoric Disorder: The 'Distressing' Condition Affecting Up To One Million Women In UK

More than one in 10 women with the disorder attempt suicide.

A large number of women in the UK could be suffering from an extreme version of PMS, which can lead to severe depression and psychosis, a leading gynaecologist has warned.

Dr Nick Panay said the condition, called pre-menstrual dysphoric disorder (PMDD), affects up to one million women in the UK and can “lead to distressing psychological and physical symptoms”.

According to Harvard Medical School, 15% of women diagnosed with the condition attempt suicide.

Dr Panay told The Independent that women “are being let down” by poor education of the public regarding the condition, poor education of health professionals and social beliefs that it’s not a “real condition”.

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PMDD is described as a more intense version of pre-menstrual syndrome.

Dr Panay said it affects roughly 5-10% of women in the UK (meaning it could affect “up to one million sufferers in the UK alone”) and can cause symptoms so severe it stops them from living normal lives.

The gynaecological expert from Chelsea and Westminster Hospital said: “The psychological symptoms [of PMDD] such as mood changes, irritability and loss of confidence are particularly distressing, leading to difficulties functioning in personal relationships, socially and professionally.”

According to the NHS, symptoms of the condition can include:

  • feelings of hopelessness
  • persistent sadness or depression, which can lead to suicidal thoughts
  • extreme anger and anxiety
  • decreased interest in usual activities
  • sleeping much more or less than usual
  • very low self-esteem
  • extreme tension and irritability

Dr Panay added that some women can even experience psychosis, where thoughts and emotions are so impaired that they lose touch with reality, and hallucinations.


PMDD is diagnosed when a woman’s symptoms seriously affect their relationships or stop them functioning properly at work.

“There is no blood test or x-ray that will diagnose PMS so really it is a case of listening to the symptoms and then equating them with the menstrual cycle,” Dr Helen Webberley, a GP for Oxford Online Pharmacy, told The Huffington Post UK.

“Although the term PMS implies that it happens at the beginning of the cycle, this isn’t always the case and some people experience symptoms at other times.

“It is usually the pattern that is established, that it happens at the same time every month, that helps with diagnosis.”

It is important that women experiencing these symptoms speak to their GP, who may then refer them to a mental health specialist for further assessment and treatment.


According to Dr Panay, PMDD is rarely discussed and medical students receive little or no training on the issue. Academic research about it is also limited.

Harvard Medical School experts write that although the condition is “sometimes dismissed as trivial, it can disrupt a woman’s life and relationships so completely, she may despair that life itself is not worth living”.

“About 15% of women with PMDD attempt suicide,” the site reads. “Fortunately, treatment options exist for PMDD — but the most effective are not always prescribed.”

Dr Webberley said some people may find hypnotherapy and CBT useful for preventing symptoms or helping to manage them.

“Some people use vitamins and supplements, and in other cases they take hormone therapies to flatten out the cycle,” she added.

Harvard experts said antidepressants that slow the re-uptake of serotonin “provide effective treatment” for the disorder.

“These drugs alleviate PMDD more quickly than depression, which means that women don’t necessarily have to take the drugs every day,” they wrote.

“Some dietary and lifestyle changes may also help.”

Useful websites and helplines:

Mind - open Monday to Friday, 9am-6pm on 0300 123 3393.

Samaritans - offers a listening service which is open 24 hours a day, on 116 123 (UK and ROI - this number is FREE to call and will not appear on your phone bill).

Get Connected - a free advice service for people under 25. Call 0808 808 4994 or email: